1. C o v e r a g e Y o u C a n C o u n t O n
For your healthcare needs, you trust only a professional.
For your medical insurance, trust Blue Cross.
We make sure “professional” also means “personal”.
Blue Royale
A worldwide Dollar plan that gives you
complete freedom of choice for the best medical care

2. The rising costs of hospitalization and medical treatment are one of the pressures you have to deal with in today’s times.
When illness strikes, you undoubtedly want to look for the best ways to secure you and your loved ones. Blue Cross
can help you financially prepare for life’s uncertainties with the Blue Royale Medical Insurance Plan.
Blue Royale offers the most comprehensive range of medical insurance benefits available in the Philippines. It offers you
complete freedom of choice to be treated by whom you please, when you please and where you please—anywhere in
the world! Blue Royale provides an impressive coverage limit of up to US$2,000,000 each year. You are also assured of
swift reimbursement of eligible charges.
• Your choice of hospital, clinic, pharmacy and doctor... WORLDWIDE!
• Maximum coverage of up to US$ 2,000,000
• Swift reimbursement of eligible charges
• Maternity benefit
• Worldwide emergency assistance
• Emergency evacuation services
• Optional out-patient coverage for dental & vision
• Transport of mortal remains
• Available under Blue Royale (for infants to 65 years old) and
Blue Royale Premier (66 years old and up) *
Blue
Royale
Q: How do I get a Blue Royale Medical Insurance Plan?
A: Contact our Medical Sales office at (632) 899-8001 or e-mail us at medical_sales@bluecross.com.ph. Our
Account Executives will be more than happy to answer your questions or give you a free presentation in person.
Q: How do I pay my Blue Royale Premium?
A: Blue Cross offers you several convenient ways to pay your premium: You can pay in cash or credit, via bank
Bills Payment Facilities, either annually or semi-annually.
Q: Do I need to undergo a physical examination before I can get a Blue Cross Insurance plan?
A: No, applicants normally do not need to undergo a physical exam. All you have to do is answer the application
form and medical questionnaire as truthfully as possible. Failure to answer the questions in the declaration in
full, concealment, or misrepresentation of any significant condition will affect your Policy and the payment of
your claims.
Q: What is a pre-existing condition?
A: A pre-existing condition is a disability or illness which existed before the commencement of cover. The existence
of a pre-existing condition can be clinically determined given its natural history, irrespective of whether or not the
insured is aware of the illness or condition. Providing cover for a pre-existing condition is subject to evaluation
by our Medical Director, and if it is excluded from cover we will notify the insured accordingly.
Q: How soon can I avail of my Blue Royale Benefits?
A: You can avail of your Blue Royale Benefits thirty (30) days after the date shown on your Policy. However, you
already have immediate coverage for accidental injury.
Q: How can Blue Royale take care of me when I am abroad?
A: In the event that you are hospitalized while abroad, our worldwide emergency assistance partner will be there
to help you. Blue Cross includes coverage for a maximum of 90 days abroad per trip. Coverage is extended
beyond 90 days provided the reason for going abroad is not to seek medical treatment. The extension of stay
overseas must also be due to an emergency illness or condition (leading to confinement) that arose on or before
your 90th
day abroad, for which the continued hospitalization will require you to stay abroad beyond 90 days.
Q: What does “90 day per trip coverage” mean?
A: This means that you can travel an unlimited number of trips outside the Philippines with insurance coverage
provided that each trip does not exceed ninety (90) days. Premium may change for overseas stay of more than
90 days.
Frequently Asked Questions
(For New Applicants)
* See insert for more information on Blue Royale Premier.

3. CORE BENEFITS
Plan B
$1,000,000
$600
As Charged
As Charged
As Charged
As Charged
As Charged
As Charged
$200,000
$10,000
As Charged
As Charged
$1,500
$400
$5,000
As Charged
As Charged
As Charged
Included
Plan C
$2,000,000
$850
As Charged
As Charged
As Charged
As Charged
As Charged
As Charged
$200,000
$10,000
As Charged
As Charged
$1,500
$500
$6,000
As Charged
As Charged
As Charged
Included
Plan A
$500,000
$300
As Charged
As Charged
As Charged
As Charged
$30,000
35% of Surgeon’s Fees
$100,000
$5,000
As Charged
90 day post-
hospitalization
follow-up care only
not available
not available
not available
As Charged
As Charged
As Charged
Included
MAXIMUM COVERAGE PER YEAR (aggregate limit per year)
IN-PATIENT BENEFITS
Room and Board
includinggeneralnursingcareforamaximumof45daysperdisability,peryearforconfinementabroad.
Unlimited number of days for confinement in the Philippines.
Miscellaneous In-Patient Charges
forrequireddiagnosticlaboratorytests;prescribedmedicinesandsupplements;bloodandcomponents;
anaesthesia; surgical appliances and devices; and intra-operative standard prosthetics (as approved
by Blue Cross)
Professional Fee
Intensive Care Unit, Coronary Care Unit, Telemetry
Operating Theater & Recovery Room
Surgeon’s Fee
includespre-surgicalassessmentandnormalpost-surgicalcarewhileconfinedinthetreatmentcountry
for each disability.
Anaesthetist’s Fee
Organ Transplant
fees for kidney, heart, liver, lungs and bone marrow transplants (as approved by Blue Cross) including
follow up treatment and sequelae to a limit per year of
Mental and Nervous Disorders
covering biologically based mental illness and degenerative brain disorder as defined in the Policy.
$5,000 per year with lifetime limit of
Private Duty Nurse
when certified necessary by the attending physician (at home for up to 30 days immediately after
hospitalization)
Procedure Done on an Out-Patient Basis
for selected procedures as approved by Blue Cross
OUT-PATIENT BENEFITS
physician and specialist fees for office visits; physiotherapist; chiropractor, acupuncturist, Chinese
medicinepractitionerandherbalistwhenreferredbyattendingphysician;requireddiagnosticlaboratory
procedures, prescribed medicines and supplements; herbal and Chinese medicines; durable medical
equipment & corrective devices as approved by Blue Cross
Other Alternative Treatments
Homeopathy; Osteopathic Manipulative Therapy (OMT); Bonesetter; Iridology and any
medication prescribed by the mentioned alternative treatments to a limit per year of
Executive Check-Up (ECU) Package *
Reimbursement only.Available to each Insured Person starting on his/her fourth year with
Blue Cross, provided that he/she has maintained any of the Blue Royale Plans (A, B or
C) for the past three (3) consecutive years and is covered under Blue Royale Plan B or
C upon Policy renewal. The Insured Person must be 20 to 65 years old upon effective
date/renewal date. Blue Cross pays 80% of ECU package availed of at any hospital or
clinic within the Philippines (selective procedures are not allowed). One time package
availment per year, to a limit of
* ECU availment may be done after full payment of annual premium or after full payment
of both semi-annual premiums.
* Group accounts’ ECU is subject to underwriting guidelines.
MATERNITY BENEFIT
all inclusive limit per pregnancy, after a 12 month waiting period
EMERGENCY BENEFITS
Emergency Out-Patient Treatment
for treatment of emergency cases/conditions not leading to confinement provided by the out-patient
department of a hospital or a licensed doctor in his clinic for a covered disability
Emergency Dental Services
due to a covered accident
Emergency Local Ambulance Service
from place of occurrence to the nearest hospital facility or from hospital to hospital using land
transportation service. If local land transportation facility is not available, other transportation facilities
are allowed subject to the approval of Blue Cross.
Emergency Overseas Coverage
overseas cover is for an unlimited number of trips outside the Philippines, provided that each trip does
not exceed ninety (90) days except if Treatment Area Limitation (TAL) discount option is selected.
Worldwide Emergency Assistance
BlueCross,throughouremergencyassistancepartner,willprovidetheassistanceandadvice(24hours
a day, 7 days a week) for free but the client will be responsible for any third party charges incurred as
Subject to the limit of In-Patient Benefits
We want to give you something priceless --- peace of mind.

4. a result of such advice or assistance unless otherwise specified elsewhere in the Policy.
Insured Person must be traveling 100 miles (or 150 kilometers) or more from his primary
and legal address or in another country which is not his Country of Residence for less
than 91 days unless otherwise endorsed in the Policy.
Services* include but are not limited to the following:
• Emergency Medical Evacuation: Evacuation under appropriate medical
supervision to the nearest medical facility
• Medical Repatriation: Repatriation under medical supervision to the Insured
Person’s legal residence or to a medical or rehabilitation facility near the Insured
Person’s residence
• Return of Mortal Remains: The return of mortal remains will be arranged and paid for.
• Compassionate Visit: When an Insured Person is traveling alone and will be
hospitalized for more than 7 consecutive days, an economy, round- trip, common
carrier transportation will be provided to a family member or a friend to accompany
the Insured Person.
• CareofMinorChild(ren): One-wayeconomycommoncarriertransportationwillbe
provided to the place of residence of minor child(ren) when they are left unattended
as a result of medical emergency or death of an Insured Person.
* Availment of services through our designated assistance provider, limit
per year of
* Availment of services not through our designated assistance provider,
limit per year of
The actual cost will be paid via reimbursement by the Company subject to the limits
specified which will form part of the Maximum Coverage Limit of the plan provided that
such assistance is a result of a covered illness, accidental injury or death occurring
during the Period of Insurance.
VALUE ADDED BENEFITS
Blue Cross Health Care Card
treatment at all Blue Cross accredited medical facilities in the Philippines, up to plan
limits with no cash outlay
Sports Coverage
for recreational sports including skiing and scuba; excluding contact sports (subject to
Policy limits)
Free Child Coverage
freecoverageforinfantfrom15daysolduptoPolicyrenewal(foranewbornofafemaleinsured)
Included (IP& ER only)
Included
Included
Included
Included
Included
Included
Included
Included
Plan A Plan B Plan CEMERGENCY BENEFITS
As Charged and on top of the Maximum Coverage Limit
As Charged and part of the Maximum Coverage Limit
OPTIONAL Benefits
Plan A
not available
1st
Year: $1,000
2nd
Year Onwards: $2,000
Plan B
$500
available for groups
of 21 members or more
1st
Year: $1,000
2nd
Year Onwards: $2,000
Plan C
$500
(Included in Core Benefits)
1st
Year: $1,000
2nd
Year Onwards: $2,000
(Included in Core Benefits)
Coverage is available as an option; from $100,000 to $500,000.
Rates for Class 1 (Standard Risk) Occupation = $1.32 per $1,000
Covers new clients age 16 to 60. Renewable until age 65.
Personal Accident Benefit
includes coverage for loss of life, loss of one or both hands or feet, loss of
vision in one or both eyes, or permanent disability caused directly and solely
by accident.
Vision Benefit
pays80%ofeyeexamsandprescription lenses viareimbursement,annuallimit
Dental Benefit
pays 80% of charges via reimbursement, annual limit
The ff. dental benefits are covered from the 1st year onwards: Dentures (as a result of accident only), Routine Oral Examination (not to exceed 2 per year),
Oral Prophylaxis (not to exceed 2 per year), Fluoride Treatment (one treatment per year), Amalgam Filling (per surface), Anterior Fillings (per surface), Root
Canal Fillings, Simple Extraction, Pits & Fissure Sealant (one treatment per year only), Dental X-rays
The ff. dental benefits are covered from the 2nd year onwards: Complex Extraction, Surgical (Impacted Wisdom Tooth/Apicoectomy ),Periodontal Surgery,
Crowns, Bridges, Compound Inlay/Onlay, Gold Inlay/Onlay, Porcelain Inlay/Onlay
Limits
US$350
(limit per year)
US$280
(limit per year)
BENEFITS
Consultation in Doctor’s Office
covers physician’s fee and specialist’s fee, maximum of
12 visits per year
Physiotherapist or Chiropractor
maximumof10treatmentsperyear,limitofonevisitperday
Limits
US$50
(limit per visit)
US$50
(limit per visit)
Out-Patient Benefits (for PLAN A only)
Blue Cross pays 80% of eligible claimed amount for reasonable, normal and customary fees. Reimbursement only.
BENEFITS
Medicines and Drugs prescribed by a Doctor
for a covered condition or disability and procured from a
recognized pharmacy
Diagnostic, X-rays and Laboratory tests
necessary for the treatment of a covered disability

5. DISCOUNT OPTIONS
$1,000 Deductible Option
$2,500 Deductible Option
$5,000 Deductible Option
Treatment Area Limitation
Plan A
15% Discount
30% Discount
40% Discount
25% Discount
Plan B
not available
18% Discount
24% Discount
25% Discount
Plan C
not available
18% Discount
24% Discount
25% Discount
Notes for Discount Options
1. The percentage discounts are not applicable to optional benefits.
2. Deductiblesarecomputedonaperannumbasisandappliedtothefollowing:
a. in-patient benefits
b. 90 days post hospitalization follow-up care benefits
3. Treatment Area Limitation excludes treatment in North American countries
such as Canada, United States of America, its dependent territories and the
Caribbean Islands; Japan & China including Hong Kong.
Aswithallinsurance,therearesomeimportantpointsyoushouldknowbeforeenteringintoacontract. Inthissection,weidentifysomekeyPolicyprovisions.
SOME THINGS ALL APPLICANTS SHOULD KNOW:
1. Your coverage begins thirty (30) days after the date shown on your Policy. However,
you already have immediate coverage for accidental injury.
2. A pre-existing condition is a disability or illness which existed before the
commencement of cover. The existence of a pre-existing condition can be clinically
determined given its natural history, irrespective of whether or not the insured is aware
of the illness or condition. Providing cover for a pre-existing condition is subject to
evaluation by our Medical Director, and if it is excluded from cover we will notify the
insured accordingly.
3. While your Policy is issued in the Philippines, it provides coverage when you are
overseas for an unlimited number of trips. However, please note that the maximum
period of cover is for 90 days per trip only. Beyond that, your plan will be subject to
additional premium. If you reside overseas, please advise us as your premium may
need to be adjusted.
4. Certainconditionsarepermanentlyexcludedfrombeingcovered. Theseconditionsinclude:
• Congenital conditions, birth defect and abnormalities
• Cosmetic surgery or related complications, contact lenses, hearing aids and
prescriptions thereof, except those that may be required for reconstructive surgery
• Suicide, attempted suicide or intentional self-inflicted injury
• Pre-existing conditions unless such have been declared and approved by the
Company
• Acquired Immune Deficiency Syndrome (AIDS), Aids Related Complex (ARC), and
Sexually Transmitted Diseases (STDs)
• All contraceptive methods of birth control; screening and/or treatment pertaining to
infertility
• Pregnancy related expense and screening, childbirth (including surgical delivery);
miscarriage and abortion, including their complications; pre-natal or post-natal care
as well as nursing care for the newborn unless provided in the schedule of benefits
• Weight treatment, management and its complications
• Confinement wholly for routine medical examinations or check-ups
5. Your contract is guaranteed renewable up to age 100. However, we reserve the right
to adjust your premium and other Policy conditions upon written advice 45 days prior
to each renewal.
6. For full details, please refer to the Policy.
as of 1 July 2013
* Vision Benefits under Plan B are only available for groups of 21 members or more who all opt for the benefit (no exception).
** Dental and Vision benefits are already included.
Premiums are inclusive of all applicable taxes.
ANNUAL PREMIUMS
PLAN A
Core Benefits
Dental Benefits
Out-Patient Benefits
PLAN B
Core Benefits
Dental Benefits
Vision Benefits *
PLAN C
Core Benefits **
0-3
$861
310
259
1,352
310
154
1,699
4-18
$913
634
259
1,433
634
154
2,103
19-25
$944
634
250
1,947
634
154
2,424
26-30
$1,055
634
250
2,429
634
154
3,049
31-35
$1,155
634
250
2,665
634
154
3,269
36-40
$1,278
634
250
2,899
634
154
3,438
41-45
$1,435
634
406
3,125
634
154
3,581
46-50
$1,545
634
406
3,320
634
154
3,732
51-55
$1,673
634
529
3,444
634
154
3,842
56-60
$1,792
634
529
3,732
634
154
4,148
61-65
$1,956
634
529
4,287
634
154
4,780
The Documentary Stamp Tax (DST - $2.00) should be deducted from the Core Benefits Premium before applying any discount and/or
loading (i.e., additional premium). The DST should be added back after all discounts and loadings have been applied.
Notes for Out-Patient Benefits
1. Out-Patient benefits provide worldwide coverage except for the Out-Patient
Executive Check-Up (OP ECU) Package.
2. For New Business, benefit availment is subject to 30 days waiting period and
the pre-existing provision of the Policy.
The following are not covered under the Blue RoyaleAOptional Out-Patient
Benefits:
1. Pre and post-natal care as well as nursing care for the newborn
2. Prosthetic devices, graft, durable medical equipment and corrective devices
3. Vitamins and supplements prescribed for an out-patient treatment
4. Over-the-counter medicines unless prescribed by a registered physician or
Chinese medicine practitioner
5. Care or treatment by herbalist, bonesetter, hypnotherapist, acupuncturist,
osteopath, homeopath or any procedure or treatment not yet acceptable
as standard of practice by the duly recognized medical specialty society or
organization
6. Routine physical examinations, health check-ups or tests not related to
treatment or diagnosis of a covered sickness or injury or any treatment
which is not medically necessary
7. Expensesforthetreatmentofpsychotic,mentalornervous/anxietydisorders,
organ transplantation, auto-immune conditions and their complications

6. Blue Cross is excellence.
We are committed to bringing nothing but the best to our
clients. Our decisions are based on an intricate understanding
of our clients’ needs, demands and expectations. We strive
to create and innovate programs that will best serve our
customers.
Blue Cross is stability.
We are one of the leading and most financially stable
companies in the industry today. Our Premiums Earned in
recent years put us in the top 20 non-life insurance companies
in the Philippines.
Blue Cross is experience.
We draw from more than fifty years of experience in the
insurance industry. Our actions are guided by a deep insight
brought about by the knowledge we have gained through the
years.
Blue Cross is customer service.
We are rooted in a commitment to ever improving
customer service. We aim to be continuously progressive and
professional. Our commendable track record and competent
support staff ensure that you are given immediate and
excellent service at all times.
Blue Cross is a partnership of trust.
We build and value enduring relationships. We
consistently prove that we are worthy of the highest
confidence---by our strict standards, the integrity of our
promises and the results we deliver. In the event of a crisis,
we assure you that Blue Cross will be your friend and ally.
H E A D O F F I C E
Blue Cross Center, 8000 Makati Avenue, 1200 Makati City,
Metro Manila, Philippines
Tel. No.: +63 2 899-8001 Fax No. : +63 2 325-0638
Email: medical_sales@bluecross.com.ph Website: www.bluecross.com.ph
S U B I C
Suite 64, West Gate Bldg., Sampson Road,
Subic Bay Freeport Zone, Zambales
Tel. No.: +63 47 250-0197 Telefax: +63 47 250-0199
Email: subic@bluecross.com.ph
C E B U
Unit 3, G/F Zeraus Bldg., Gorordo Avenue,
Brgy. Kamputhaw, Cebu City
Tel. Nos.: +63 32 233-5812; +63 32 233-5816; +63 32 416-4468
Fax No.: +63 32 233-5814 Email: cebu@bluecross.com.ph
D A V A O
2nd
Floor, Left Wing, Door No. 6, Matina Town Square,
Mac Arthur Highway, Matina, Davao City
Tel. No.: +63 82 297-7314 Telefax: +63 82 297-7151
Email: davao@bluecross.com.ph
V07.13_PI & Ben
w w w. b l u e c r o s s . c o m . p h
he Name
we live by...
T